Caring for Hickman line - Essay Example

? Development of a teaching plan al affiliation Development of a teaching plan Learning needs analysis In the clinical environments, there has always been a need to conduct various procedures in an attempt to conduct procedural skillfulness that can be applied in factual life clinical setting. Garcarz, Chambers and Ellis (2003) argue that, it is important that learning needs are identified within the clinical setting in order, to be in an enhanced position to recognize and perform appropriate clinical procedures at the moment. Through establishing a need in clinical teaching, patients’ medical background necessary for conducting investigations is possible. Learning needs analysis allows for accurate clinical investigations that are in line with the patients’ medical history. This case study shall focus on the need to allow individual be aware of the their abilities to be conversant with learning needs, readiness to learn, abilities to learn, prior experience & learning, learning styles and time available to learn in the clinical setting. This case study shall also assess the organization and assess the professional & service users' needs. This theme of caring for the Hickman Line was arrived at by the growing statistics of the exposure of the Lines to germs. As a result, of careless storage of Hickman lines with no proper care, a lot of infections have recorded an escalating trend. A greater percentage of patients have been seen to visit health centers for replacement of the Hickman lines; others require removal of the same. Learner’s learning needs analysis According to Souhami and Moxham (2002) proper insertion of the Hickman Line is a concern of the learners in the clinical setting. Nurses, the learners in this context, are no exception to the needs analysis on the placement of the Hickman line. Billet (2011) argues that, in the clinical setting, nurses must be actively involved in learning in the clinical setting. All health practitioners must ensure that they are conversant with all the procedures that are required of them in the clinical setting. Conducting successful insertion of the Hickman line is an indication of a well trained physician (Feldman, 2008). Alternatively, provision of appropriate procedure to the patient is a requirement of the nurse in clinical practice. The nurse must be very alert while conducting the procedure of inserting the Hickman line. Direct observation is not the only vital action that needs to be taken by nurses (Gopee, 2010). He continues to argue in the clinical setting, the nurse must have self-possessed assessment skills that are extremely important in this case study. Despite the fact that, acquisition of these skills may pose a major challenge in the clinical setting, patient care must be jeopardized by the fact that nurses need time to adjust to the new practice (Gopee, 2010). In relation to this case study, nurses must ensure that they are conversant with the Hickman line insertion procedure, that commences with neck X-rays. Nurses must also be keen on administering pain killers before insertion of the Line. Needs analysis, in this context, is responsible for ensuring that nurses conduct their roles as expected, so as, the patients have an uncomplicated and calm operation. Caley (2006) argues that, health improvement must be the sole purpose for the provision of health care to individuals. Teaching plan objectives In relation to part 1, the teaching plan will be based on Nursing as the Subject area. The theme of the teaching plan will be successful completion of the Hickman Line placement. In regard to the teaching plan goals, the tutor must ensure that the learners’ -nurses-scope of ability to grasp key elements of placement of the Hickman line. The tutors must also emphasize on the need to assemble all the skills learnt throughout the course are applied in the clinical setting. Teaching plan must also ensure that the health practitioners are in a position to convert all the theoretical skills to practical during insertion of the Hickman line. Learners must also embrace all the terminologies elaborated by the tutor are incorporated in the practical setting. Embrace of all concepts of the successful insertion of the Hickman line must be the sole objective of the teaching plan. Target group Medical students, nurses to be specific, are the major beneficiaries of this teaching plan. Nurses will be educated on the need to observe the manner in which patients are being treated by the superior nurse, examination of the patient as well as, revealing of bad news, in case a tragic situation occurs. Content to be covered In this process, the nurses must be in a position to differentiate various signals, like the red lumen that is useful for carrying out donation of blood products or taking samples of blood while the blue lumen administering medications and IV fluids. Throughout the teaching plan, the nurses must be keen to check to what extent the catheter is inserted on the patients’ chest and what part of the catheter should be above the heart’s major vein. The nurses grasp all the details of the ‘ex-site’ process; a move that avoids a situation where the insertion of the Hickman line may not be up to snuff. It is vital that infections are detected during the insertion of the Hickman line. This is an explanation of Infections as a crucial content area under scrutiny. Analysts in the field of health care argue that, infections remain a contentious issue in practice as well as, teaching in the heath care setting (Hafler, 2011). The major cause of infections that are related to the Hickman Line is exposure to germs. Upon infection, it is vital that nurses are made aware of the need to advice patients to undergo a process of removal of the Line. Dealing with infections In the context of infections, nurses are advised to learn the simple symptoms that relate to infections (Kneebone et al, 2002). Among the symptoms include warm or hot skin in the region of the exit site, swollen and redness of skin around the area, faster heart beats and intense fevers by the patients. As a mode of prevention of infections, preventive measures are incorporated in the contents under study. In the teaching plan, tutors must include an integrative approach on teaching of cleaning of hands before handling the Lines. Nurses must be keen to advise patients on the need to follow all instructions in the kit, proper use of syringes, storage and regularity of use of syringes. Incorporation of this content of study allows patients and nurses have a clear distinction of the dos and don’ts of the clinical environment, as far as Hickman Lines are concerned constant observation of the patient, under study goes a long way in the successful insertion and adaptation by the patient (Jolly and Wass, 2001). Blood check Blood check is an important content in clinical settings that deal with Hickman lines. Souhami and Moxham (2002) indicate that in order to check blood, nurses must ensure that the catheter is flushed so as to ensure that the Line is in the right position of the vein. The process of blood check must be explained in detailed so that the nurses do not pose life threats on the patients. The tutor must ensure that the nurses are able to pull the plunger of the saline syringe softly; then the nurse must watch if blood has moved into the syringe for them to conduct the flushing exercise. In instances when there is no blood, the nurse must change the positioning of the patient then pull the plunger once more. This is a major step that has to be focused on by all health practitioners. At times, the nurse may opt to flush an amount of saline in the syringe or in times of intense situations; they may inject the saline solution to the patient. After the process, it is the responsibility of the tutor to ensure that, they disconnect the syringe and fasten the Hickman Line. In the course of blood check, nurses must also be educated on the need not to employ force while injecting saline solution on the patient. Nurses must also learn that emergency cases must be reported to the family doctor and that they should always avoid taking matters into their own hands. Maintaining pressure According to Souhami and Moxham (2002) maintaining upbeat pressure is important as far as Hickman Line is concerned. If pressure is not maintained, there is a great likelihood that air might get into the Line, thus prevent blood from entering the lumen- a likelihood that clotting may take place. In this case, the lumen may end up being annulled. It is advisable, that if one is flushing the Hickman line, the clamp must be tight enough and the syringe disconnected. In this context, the patient’s life is safe while the Hickman Line can go for a long time. Hickman Line dressing For the Hickman line to go for a long time, dressing must take place regularly to avoid infections. Tosh (2007) advises that dressing must take place at least, once in every week. Nurses must put on masks in case they have a cold or cough infections. The nurses must also ensure that the amount of Chlorhexedine Gluconate used to clean be of the right amount, 0.5% while the Isopropyl Alcohol must also be 70%. The tutors should be keen to check that the solution, usually branded, Soluprep, is not administered on busted skin. The solution has been known over the years to have a high bleaching effect that can cause adverse effects on the patients’ skin. While dressing the patient, the nurse must ensure that their hands are clean; they have collected necessary material required during the process (Struthers and Westran, 2003).Another key procedure is that the nurse must gently pull the previous dressing towards the exit site; the nurse must be keen not to touch the exit site bare handed. The tutor must also ensure that they discern all signs of infection that may be detected in the patient. Upon detection of infections, gauze dressing should be applied. The exit site must always be clean, and the nurse should make rounds on the site twice, then discard all swabs. The catheter must also be cleaned using Soluprep swab using swabs at all sides. Finally, the catheter must be must be secured using the ‘bulldog’ clamp after dressing has been done circumspectly. The minute details of disposing the used swabs and cleaning of hands must not be forgotten. Irritating skin must be dressed and monitored daily. After six weeks, it is expected that exit site is healed. In the course of covering this content, the tutor must ensure that all details are covered and adhered to completely. Perceived challenges According to Swanwick (2011), over the years, it has been extremely difficult to conduct successful clinical education. In response, it has become extremely important to incorporate students in the teaching and learning context (Celermajer, Joshua and Stockler, 2005). With the incorporation of learners in the teaching setting makes it extremely easy for learners to grasp concepts that recommended going through a medical course. Role modeling is recommended as a teaching strategy. This form of teaching has had massive impacts on the students, as they are able to bring to mind what they learnt in the clinical setting. Role modeling has also allowed patients encounter their learning environments one on one. Clinicians are also in a position to apply what they acquired theoretically in a practical setting. In relation to this case study, clinicians are able to understand how to approach patients, as well as, to ensure that the Hickman Line is well inserted in the patient’s body. It is evident that clinicians who has undergone practical in the learning setting are likely to produce results unlike clinicians who have only learnt theoretical skills. Clinical teachers must always be ready to incorporate role modeling as a teaching strategy. Medical students are more likely to observe what is being done in the clinical setting; in turn apply what they acquired in the clinical setting. Since medicine is a practical subject Ende and American College of Physicians (2010) argue, that there is no option but to incorporate practical skills in teaching. Incorporation of passive learners does not hold much need to the medical setting. Effective teaching should incorporate stimulating and interactive know-how in the learning setting. This is a call to all medical teachers of medical related contexts to incorporate additional organizational expertise whilst in the course of study. Assessment Assessment in the clinical setting needs to assess the service needs and demands. In terms of the reality need the formative assessment may be applied. Kember (2008) argues that this form of assessment takes place at some stages in the lesson. The tutor is more often than not, very ardent in terms of clinicians mastery of concepts in the medical set up. It is during the erudition period that the tutors allow clinicians come up with solutions on various tests that relate to the procedure of inserting the Hickman Line or even maintenance. During the study, clinicians are required to fill up journals concerning care for the Hickman Line based on their observations and research performed. The tutor must also ensure that they incorporate the use scientific strategies to validate their research through a prearranged investigation of the actions embarked on to obtain tangible conclusion. The advancement of the learners is strictly scrutinized by the tutor in the course of the teaching and learning procedure. In order to assess the service needs, or rather the real needs, the health practitioner may apply the use of interviews, questionnaires, observation techniques and individual self evaluation in order to analyze the learners' abilities to perform various tasks in the clinical setting. On the other hand, to have a clear understanding on the ability of the learners to cope with professional wants, the tutor in the clinical setting must be quick to identify critical incidents that the learners display in the clinical setting. Summative assessment takes place at the end of the clinical practice (Welsh and Swann, 2002). The teacher should give the adult learners a final assessment on all the concepts learnt regarding the Hickman Line. In this context, the tutor must check the ability of the learners to carry out research that is valid and reliable. In line to this argument, the tutor is able to discern if the learner is suitable for the job in the clinical setting. The major learning objective is that the learners must always satisfy the expectations of their clients. The tutor can only ensure that this is achieved by conducting performance review data on the groups concerned then coming up with a review of the competency requirements. Clinicians must also be given an opportunity to come up with Portfolios on all phases they have learnt regarding Hickman Lines. These portfolios will act as a gauge of the ideas learnt by the clinicians under the course of study. The teacher must analyze the portfolios to evaluate if concepts on care for the Hickman Line are grasped by the clinicians. Challenges in teaching plan implementation Among the challenges that are likely to take shape in the clinical setting is the use of real patients (Peyton, 2001). At times, some patients are not comfortable with student health practitioners. Some of these patients are completely unfriendly and unwilling to cooperate with the clinicians. The adult learners on the other hand, are sometimes not tolerant with patients in the clinical setting. Bradley and Ker (2007) argue that it is only patients that can make learning make sense unlike in instances when learners had to endure endless stories on medical practices. In order to handle this situation, the tutor must establish a rapport with the patients prior to the lesson with patients. Good communication with the patients will be of benefit to mastery of concepts in the teaching and learning context (Jones, Van der Vleuten and Wass, 2004). The tutor must also consider submitting written consents to patients unlike oral modes of offering consent to the patients. In this case, patients will not envisage that they are being used for practical but will appreciate the fact that their consent is required to successfully complete teaching in the clinical setting (Azer, 2007). Summary References Azer, S. (2007). Navigating Problem-Based Learning. Australia: Elsevier Australia. 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New York: John Wiley & Sons. Tosh, M. (2007). Living Proof: A Medical Mutiny. London: Simon and Schuster. Welsh, I. and Swann, C. (2002). Partners in learning: a guide to support and assessment in nurse education. London: Radcliffe Publishing. Read More